Citation Nr: 0006579
Decision Date: 03/10/00 Archive Date: 03/17/00
DOCKET NO. 94-44 717 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Chicago,
Illinois
THE ISSUES
1. Entitlement to service connection for a liver disorder.
2. Entitlement to a compensable evaluation for retropatellar
tendonitis of the right knee.
REPRESENTATION
Appellant represented by: AMVETS
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
Robert W. Legg, Associate Counsel
INTRODUCTION
This matter comes before the Board of Veterans' Appeals (BVA
or Board) on appeal from a June 1993 rating decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Chicago, Illinois. The veteran had active service from March
1990 to March 1993.
In June 1997, the Board remanded the veteran's claim for
further development. For the reasons that follow in the
REMAND portion of this decision, additional action is
required before the Board can render an informed decision on
this claim.
FINDINGS OF FACT
1. In 1992, during his active service, the veteran was noted
to have had abnormal liver function tests related to his
activity with fuels.
2. In an August 1994 VA examination, the veteran was
diagnosed with chemical hepatitis secondary to Benzene
exposure, by history, with minimal elevation of a liver
function test noted at that time.
CONCLUSION OF LAW
The veteran's claim for service connection for a liver
disorder is well grounded. 38 U.S.C.A. § 5107(a) (West
1991).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
Service connection may be granted for a disability resulting
from disease or injury incurred in or aggravated by a
veteran's active service. See 38 U.S.C.A. §§ 1110, 1131
(West 1991); 38 C.F.R. § 3.303 (1999).
To establish that a claim for service connection is well
grounded, a veteran must demonstrate the incurrence or
aggravation of a disease or injury in service, the existence
of a current disability, and a nexus between the in-service
injury or disease and the current disability. Medical
evidence is required to prove the existence of a current
disability and to fulfill the nexus requirement. Lay or
medical evidence, as appropriate, may be used to substantiate
service incurrence. Epps v. Gober, 126 F.3d 1464 (1997).
Service medical records reflect that in March 1992 the
veteran had complaints of lightheadedness and headaches after
refueling tanker trucks with jet fuel. Elevated liver
function tests were referenced, and possible overexposure to
jet fuel fumes was diagnosed. Follow-up records throughout
1992 noted elevated liver studies, and substantially
consistent through this time frame the veteran was diagnosed
with excessive exposure to jet fuel. An August 1994 VA
examination report diagnosed the veteran with chronic
chemical hepatitis, secondary to Benzene exposure, by
history.
As the veteran had in-service exposure to fuel, developed
some abnormal liver function tests as a result, and currently
has a diagnosis of chemical hepatitis by history, the Board
finds that his claim is well grounded. However, for the
reasons that follow, the Board also finds that further
information is required before an informed decision can be
made in evaluating the merits of the claim.
ORDER
The veteran's claim for service connection for a liver
disorder is well grounded.
REMAND
A preliminary review of the record discloses that the veteran
was scheduled for VA examinations in April 1998 as a result
of the prior REMAND. However, the record indicates that the
veteran canceled these examinations, indicating that he had
started a new job and was unable to get time off from work.
However, in correspondence dated August 1999, the veteran
essentially indicated that he was able to report for the
examinations, and requested that examinations be scheduled in
the St. Louis, Missouri area.
In light of the above, the Board finds that further
information is required before an informed decision can be
made on the veteran's claims, and thus, these claims are
REMANDED for the following action:
1. The veteran should be afforded an VA
examination by an appropriate specialist
to determine the nature, severity and
etiology of any liver disorder which may
be present. That examiner is requested
to perform all relevant liver function
studies deemed necessary and to review
the veteran's claims file. Based upon
the veteran's service medical records and
current findings, the VA examiner is
requested to explain the veteran's in-
service findings and the results of the
veteran's current liver function. In
particular, the examiner is requested to
explain whether the veteran currently has
a liver disorder that can be reasonably
related to service or whether such is due
to any current occupational hazards. The
complete rationale for each opinion
expressed should be set forth. Since it
is important "that each disability be
viewed in relation to its history[,]" 38
C.F.R. § 4.1, the claims file must be
made available to the examiner for
review.
2. The veteran should be afforded an
appropriate VA examination to determine
the full nature and extent of his
service-connected retropatellar
tendonitis of the right knee. Any and
all indicated evaluations, studies, and
tests deemed necessary by the examiner
should be accomplished, and all clinical
findings should be reported in detail.
In particular, the examiner is asked to
comment on the range of motion of the
right knee, and to comment on the
presence or absence of objective evidence
of pain on manipulation and use, as well
as other evidence of pain on use. In
addition, the examiner is requested to
comment on the presence or absence of
laxity, instability, or subluxation of
the right knee. All examination findings
and a complete rationale for each opinion
expressed should be set forth. Since it
is important "that each disability be
viewed in relation to its history[,]"
38 C.F.R. § 4.1, the claims file must be
made available to the examiner for
review.
3. The RO should then readjudicate the
claims for service connection and for an
initial higher evaluation on the basis of
all the evidence of record, taking into
consideration whether there is evidence
of functional loss due to pain, applying
the decision in DeLuca v. Brown, 8 Vet.
App. 202 (1995). If any benefit sought
on appeal remains denied, the RO should
provide the veteran and his
representative a Supplemental Statement
of the Case, and allow an appropriate
period of time for response.
The purpose of this REMAND is to obtain additional
development, and the Board does not intimate any opinion as
to the merits of the case, either favorable or unfavorable,
at this time. The appellant is free to submit any additional
evidence and/or argument he desires to have considered in
connection with his current appeal. No action is required of
the appellant until he is notified.
RAYMOND F. FERNER
Acting Member, Board of Veterans' Appeals
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the
Board on the merits of your appeal. 38 C.F.R. § 20.1100(b)
(1999).